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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Has Neurofibromatosis. Cerebral Palsy Due To Suction Cup. Easily Distinguishable Conditions?

My son has symptoms of cerebral palsy and an IQ of 81. A psychologist who evaluated him believes he has CP but can t diagnose it because of legalities. The suction cup used during birth left a large hematoma on back left side off skull that never resolved and hardened over time. The psychologist who evaluated him said the location would explain his neuromuscular deficits, speech delays etc. my son also has Neurofibromatosis (the common kind with the cafe ole spots) so I believe the hospital will try to blame the NF if we decide to get a lawyer involved. Can these two different conditions be easily separated?
Wed, 7 Nov 2012
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General & Family Physician 's  Response
Hello. I'm sorry your son is having problems. Your psychologist was wise to refrain from diagnosing your son's condition, as diagnosing cerebral palsy (for better or worse) is legally the purview of a physician. I suspect you've probably done some research, so you may know that cephalhematomas are usually benign, and they typically clear up within a few weeks, with about 1% becoming calcified over time. (This appears to be the case with your son.) Although cephalhemotomas are generally harmless, they can be associated with complications, such as severe jaundice or an underlying skull fracture. If these complications are not addressed, they could conceivably contribute to long-term neurological problems.
Unfortunately, about half of people with neurofibromatosis-1 (the most common form) have learning disabilities, developmental delays and/or mental retardation. Thus, it will be difficult to assign your son's problems to his cephalhematoma when he's been diagnosed with neurofibromatosis. A meticulous neurological evaluation -- including imaging studies of the brain -- might shed some light on this issue, but I suspect that has already been done. If a neurologist has discovered problems that aren't typically associated with neurofibromatosis, your case might be strengthened. However, the overlap between the complications due to birth trauma and those caused by neurofibromatosis is significant.
I hope that helps, and I hope things go well for your son.
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Child Has Neurofibromatosis. Cerebral Palsy Due To Suction Cup. Easily Distinguishable Conditions?

Hello. I m sorry your son is having problems. Your psychologist was wise to refrain from diagnosing your son s condition, as diagnosing cerebral palsy (for better or worse) is legally the purview of a physician. I suspect you ve probably done some research, so you may know that cephalhematomas are usually benign, and they typically clear up within a few weeks, with about 1% becoming calcified over time. (This appears to be the case with your son.) Although cephalhemotomas are generally harmless, they can be associated with complications, such as severe jaundice or an underlying skull fracture. If these complications are not addressed, they could conceivably contribute to long-term neurological problems. Unfortunately, about half of people with neurofibromatosis-1 (the most common form) have learning disabilities, developmental delays and/or mental retardation. Thus, it will be difficult to assign your son s problems to his cephalhematoma when he s been diagnosed with neurofibromatosis. A meticulous neurological evaluation -- including imaging studies of the brain -- might shed some light on this issue, but I suspect that has already been done. If a neurologist has discovered problems that aren t typically associated with neurofibromatosis, your case might be strengthened. However, the overlap between the complications due to birth trauma and those caused by neurofibromatosis is significant. I hope that helps, and I hope things go well for your son.